强化物理干预对高血压合并阻塞性睡眠呼吸暂停的疗效

郝芳; 张丽红; 陈少伯

PDF(936 KB)

武警医学 ›› 2022, Vol. 33 ›› Issue (7) : 553-555.

论著

强化物理干预对高血压合并阻塞性睡眠呼吸暂停的疗效

郝芳¹, 张丽红², 陈少伯¹

作者信息 +

Effect of intensive physical intervention methods on hypertension patients complicated with OSA

HAO Fang¹, ZHANG Lihong², CHEN Shaobo¹

Author information +

文章历史 +

摘要

目的探讨强化物理干预方式对高血压合并阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的疗效。方法 50例Ⅰ、Ⅱ级高血压合并OSA患者随机分为常规组和干预组,两组均给予标准药物治疗和高血压常规护理,干预组强化针对OSA的物理干预,包括对OSA的健康宣教,指导和调整科学睡眠姿势,“三阴交”穴位按摩催眠法等,干预1周后,重复检测两组24 h动态血压和多导睡眠监测,评价临床疗效、血压和OSA指标变化情况。结果经过1周针对OSA的物理干预,干预组血压下降幅度和OSA指标改善程度显著优于常规组[24 h平均收缩压(131.6±12.7)mmHg vs.(138.5±13.4)mmHg;24 h平均舒张压(82.6±9.1)mmHg vs.(90.3±8.9)mmHg;AHI(10.5±5.9)次/h vs. (17.5±6.7)次/h;SPO₂(92.5%±7.8%)vs.(87.6%±8.4%)],差异均有统计学意义(P＜0.05)。结论给予高血压合并OSA患者强化物理干预,能协同有效降低血压,改善OSA指标。

Abstract

Objective To evaluate the therapy effect of intensive physical intervention methods on hypertension patients complicated with OSA.Methods Fifty patients with grade I and II hypertension complicated with OSA were randomly divided into routine group and intervention group. Both groups were given standard drug treatment and routine nursing. The intervention group were strengthened with physical intervention for OSA, including health education, guidance and adjustment of scientific sleep posture, and massage hypnosis of acupoint Sanyinjiao. After one week of intervention, 24 hour ambulatory blood pressure and polysomnography were repeatedly checked to evaluate the clinical efficacy.Results The clinical effect of the intervention group was better than that of the routine group, and the decrease of blood pressure and the improvement of OSA indexes were significantly better than those of the routine group [24 h SBP(131.6±12.7)mmHg vs.(138.5±13.4)mmHg;24 h DBP(82.6±9.1)mmHg vs.(90.3±8.9)mmHg;AHI(10.5±5.9)time/h vs.(17.5±6.7)time/h;SPO₂(92.5%±7.8%)vs.(87.6%±8.4%)]. Conclusion For patients with hypertension complicated with OSA, intensive physical intervention can effectively reduce blood pressure and improve OSA indicators, which is worthy of clinical promotion.

导出引用

郝芳, 张丽红, 陈少伯. 强化物理干预对高血压合并阻塞性睡眠呼吸暂停的疗效[J]. 武警医学. 2022, 33(7): 553-555

HAO Fang, ZHANG Lihong, CHEN Shaobo. Effect of intensive physical intervention methods on hypertension patients complicated with OSA[J]. Medical Journal of the Chinese People Armed Police Forces. 2022, 33(7): 553-555

中图分类号： R544.1

参考文献

[1] 赵力博,徐伟豪,钱小顺,等. 阻塞性睡眠呼吸暂停相关高血压的研究进展[J]. 解放军医学院学报, 2021,42(4):451-454.
[2] 中国高血压防治指南修订委员会高血压联盟(中国),中华医学会心血管病学分会,中国医师协会高血压专业委员会,等. 中国高血压防治指南(2018 年修订版) [J].中国心血管杂志,2019,24 (1):24-56.
[3] 中国医师协会睡眠专业委员会.成人睡眠呼吸暂停多学科诊疗指南[J].中华医学杂志,2018,98(24):1902-1914.
[4] 魏慧强.按摩催眠[J].中老年保健,2000,7(5):26-27.
[5] Punjabi N M, Caffo B S, Goodwin J L, et al.Sleep-disordered reathing and mortality:a prospective cohort study[J]. PLoS Med,2009,6(8):e1000132-e1000140.
[6] Elizabeth S M. Prevalence of obstructive sleep apnea in refractory hypertension [J]. Hypertension, 2018,72(10):592-593.
[7] Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults [J]. N Engl J Med,1993,328(17):1230-1235.
[8] Peppard P E, Young T, Barnet J H,et al. Increased prevalence of sleep-disordered breathing in adults [J]. Am J Epidemiol,2013,177(9):1006-1014.
[9] 中国中医药研究促进会,中西医结合心血管病预防与康复专业委员会,高血压专家委员会等. 特殊类型高血压临床诊治要点专家建议[J].中国全科医学杂志,2020, 23(4):1202-1228.
[10] Javaheri S, Barbe F, Campos-Rodriguez F, et al.Sleep apnea: types, mechanisms, and clinical cardiovascular consequences [J]. J Am Coll Cardiol,2017,69(7):841-858.
[11] Tufik S, Santos-Silva R, Taddei J A, et al. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study [J]. Sleep Med,2010,11(5):441-446.
[12] Epstein L J, Kristo D, Strollo P Jr, et al. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long term care of obstructive sleep apnea in adults[J]. J Clin Sleep Med,2009,5(3):263-276.
[13] 张莉,张晓雷,王辰. 2019年美国睡眠医学会《气道正压通气治疗成人阻塞性睡眠呼吸暂停》临床实践指南解读[J].中国实用内科杂志,2019, 39 (7):600-604.
[14] Daniel J G, Naresh M P. Diagnosis and management of obstructive sleep apnea: a review [J]. JAMA,2020,323(14):1389-1400.
[15] 许志德,沈志明,黄秀珍,等.按摩催眠术加局部麻醉应用于兔创伤模型制备[J]. 上海实验动物科学,1998,18(2):109-122.